Wikipedia:WikiProject Chemicals/Chembox validation/VerifiedDataSandbox and Icodextrin: Difference between pages

{{short description|Pharmaceutical drug}}

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| molecular_weight = 13–19

'''Icodextrin''' ([[International Nonproprietary Name|INN]], [[United States Adopted Name|USAN]]) is a [[colloid]] [[osmotic]] agent, derived from [[maltodextrin]],<ref name="maltod">{{cite book |title=Clinical evidence, Issue 14 |pages=1046 |author=American College of Physicians--American Society of Internal Medicine |year=2005 |publisher=BMJ Pub. Group}}</ref> used in form of an [[aqueous]] solution for [[peritoneal dialysis]] under the trade name '''Extraneal''',<ref name="RxList" /> and after gynecological [[laparoscopic]] surgery for the reduction of post-surgical [[adhesion (medicine)|adhesion]]s (fibrous bands that form between tissues and organs) under the trade name '''Adept'''.<ref name="FDA" />

==Chemistry==

Icodextrin is a [[starch]]-derived, branched, water-soluble [[glucose]] [[polymer]] linked by α-(1→4) and less than 10% α-(1→6) [[glycosidic bond]]s, making it a type of [[dextrin]]. Its weight-average molecular weight is between 13,000 and 19,000 [[Dalton (unit)|dalton]]s and its number-average molecular weight between 5,000 and 6,500 daltons. The substance is a white to off-white solid, and the solution is clear and colourless to pale yellow.<ref name="FDA" />

==Mechanism of action==

The osmotic activity of icodextrin keeps the solution inside the [[peritoneum]] for three to four days, separating tissues and thus reducing adhesion between them when [[fibrin]] is formed after a surgery. In other words, the tissues are kept from gluing together.<ref name="FDA" />

[[File:DP branchement.svg|thumb|left|upright|[[Peritoneal dialysis]]]]

When used for peritoneal dialysis, the icodextrin solution absorbs waste products from the blood, and is removed from the peritoneum after a few hours together with the waste.<ref>{{cite journal | vauthors = Frampton JE, Plosker GL | title = Icodextrin: a review of its use in peritoneal dialysis | journal = Drugs | volume = 63 | issue = 19 | pages = 2079–105 | year = 2003 | pmid = 12962523 | doi = 10.2165/00003495-200363190-00011 }}</ref>

==Pharmacokinetics==

Icodextrin is not significantly metabolised inside the peritoneum. Instead, it is absorbed slowly (40% after 12 hours) into the bloodstream via the [[lymph vessel]]s. There it is broken down into [[oligosaccharide]]s by the enzyme [[alpha-amylase]]. In patients with intact kidney function, both icodextrin and its fragments are excreted via the kidney by [[glomerular filtration]].<ref name="RxList">{{cite web | work = RxList.com | url = http://www.rxlist.com/extraneal-drug.htm | title = Extraneal }}</ref><ref name="FDA">{{cite web | work = FDA | url = http://www.accessdata.fda.gov/cdrh_docs/pdf5/P050011c.pdf | title = Adept (4% Icodextrin) Adhesion Reduction Solution }}</ref>

==Contraindications==

Icodextrin is contraindicated in patients with cornstarch allergy, [[maltose]] or [[isomaltose]] intolerance, [[glycogen storage disease]], or severe [[lactic acidosis]].<ref name="Drugs.com">{{cite web | work = Drugs.com | url = https://www.drugs.com/pro/extraneal.html | title = Extraneal }}</ref>

==Adverse effects==

Adverse effects include [[peritonitis]], [[respiratory infection]], [[hypertension]] (high blood pressure), [[rash]]es, and headache. Of these side effects, only hypertension and rashes occurred significantly more often than under glucose solution; the other events seem to be related to peritoneal dialysis in general.<ref name="Drugs.com" />

== Interactions ==

Icodextrin can mimic increased [[blood glucose]] levels, depending on the used testing system. Specifically, glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) or glucose-dye-oxidoreductase (GDO) based tests can erroneously show high blood glucose in patients that have been treated with icodextrin.<ref name="Drugs.com" />

== References ==

{{reflist}}

{{Blood substitutes and perfusion solutions}}

[[Category:Renal dialysis]]

[[Category:Polysaccharides]]